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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 7/2020

01-07-2020 | Lymphadenectomy | Health Services Research and Global Oncology

L1CAM Predicts Adverse Outcomes in Patients with Endometrial Cancer Undergoing Full Lymphadenectomy and Adjuvant Chemotherapy

Authors: Hiroshi Asano, MD, Kanako C. Hatanaka, MD, PhD, Ryosuke Matsuoka, MD, Peixin Dong, MD, PhD, Takashi Mitamura, MD, PhD, Yosuke Konno, MD, PhD, Tatsuya Kato, MD, Noriko Kobayashi, MD, PhD, Kei Ihira, MD, PhD, Ayako Nozaki, MD, Akira Oku, MD, Yoshihiro Matsuno, MD, PhD, Yutaka Hatanaka, PhD, Hidemichi Watari, MD, PhD

Published in: Annals of Surgical Oncology | Issue 7/2020

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Abstract

Background

L1 cell adhesion molecule (L1CAM) has been established as an important predictor of poor survival of early-stage endometrial cancer patients. We investigated whether L1CAM remains a significant predictor of poor survival of patients with advanced-stage endometrial cancer undergoing extensive surgical staging and adjuvant chemotherapy.

Methods

We prepared tissue microarray (TMA) from surgical tissue specimens of 161 endometrial cancer patients who underwent full lymphadenectomy combined with adjuvant chemotherapy for patients at risk for recurrence, and evaluated expression of L1CAM using immunohistochemistry. The correlation between L1CAM positivity and clinicopathological factors and the prognostic significance of L1CAM expression was investigated.

Results

Among 161 cases who had a follow-up duration of over 3 years, 48 cases (29.8%) showed positive staining for L1CAM. L1CAM positivity was significantly correlated with non-endometrioid histology (p < 0.0001), vascular invasion (p = 0.0157), and positive cytology (p = 0.005), and was a significant predictor of poor survival among advanced-stage patients, but not early-stage patients in our cohort. L1CAM-positive patients showed a higher recurrence rate and frequency of distant failure than L1CAM-negative patients. Multivariate analysis revealed that para-aortic lymph node metastasis (PANM) and L1CAM positivity were independent predictors of poor survival. Overall survival can be stratified into three groups by the combination of PANM and L1CAM positivity.

Conclusion

L1CAM is an independent predictor of poor survival in endometrial cancer patients undergoing full lymphadenectomy and adjuvant chemotherapy, thus indicating that L1CAM can be clinically used as a biomarker to identify those patients at increased risk of recurrence.
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Metadata
Title
L1CAM Predicts Adverse Outcomes in Patients with Endometrial Cancer Undergoing Full Lymphadenectomy and Adjuvant Chemotherapy
Authors
Hiroshi Asano, MD
Kanako C. Hatanaka, MD, PhD
Ryosuke Matsuoka, MD
Peixin Dong, MD, PhD
Takashi Mitamura, MD, PhD
Yosuke Konno, MD, PhD
Tatsuya Kato, MD
Noriko Kobayashi, MD, PhD
Kei Ihira, MD, PhD
Ayako Nozaki, MD
Akira Oku, MD
Yoshihiro Matsuno, MD, PhD
Yutaka Hatanaka, PhD
Hidemichi Watari, MD, PhD
Publication date
01-07-2020
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 7/2020
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-019-08103-2

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